Advance Care Planning (ACP)

Advance Care Planning is a Medicare-reimbursed service for discussing and documenting patient preferences for future medical care. Learn ACP billing, documentation, and implementation.

By AJ Pakpour — The Business of Modern Medicine™

Educational Summary

Advance Care Planning (ACP) is a Medicare-reimbursed service that covers the time providers spend discussing and documenting a patient's preferences for future medical care — including end-of-life care, resuscitation preferences, and the designation of healthcare proxies.

ACP conversations are among the most valuable services a provider can offer — and among the most underutilized billing opportunities in Medicare. These conversations help patients make informed decisions about their care, reduce unwanted interventions, and ensure that patients' wishes are known and respected when they can no longer speak for themselves.

Medicare reimburses for ACP regardless of whether the patient has a terminal diagnosis. Any Medicare patient can benefit from ACP, and the conversations can happen during any appropriate clinical encounter — including the Annual Wellness Visit.

Documentation requirements are straightforward: the provider must document that an ACP conversation occurred, the approximate time spent, and whether an advance directive was completed or updated. The patient must consent to the service.

Key Takeaways

• ✓ACP is reimbursable for any Medicare patient — not just those with terminal diagnoses
• ✓Can be performed during the Annual Wellness Visit or any appropriate clinical encounter
• ✓Documentation requires noting the conversation occurred, time spent, and advance directive status
• ✓ACP conversations reduce unwanted interventions and improve patient satisfaction
• ✓Separate CPT codes for first 30 minutes and each additional 30 minutes